Service Chirurgie orthopédique, traumatologie, Chirurgie plastique et Chirurgie de la main, Centre hospitalier régional universitaire de Besançon, 3, boulevard Alexandre-Fleming, 25000 Besançon, France.
Hand Surg Rehabil. 2020 Oct;39(5):423-430. doi: 10.1016/j.hansur.2020.05.003. Epub 2020 May 19.
The proximal interphalangeal (PIP) joint is particularly vulnerable to trauma. In comminuted fractures, arthroplasty with a silicone implant is a treatment option that may be controversial in an emergency setting. This joint destruction is usually accompanied by soft tissue injuries (skin and tendon damage, devascularization) making the reconstruction all the more complex. The aim of our work was to evaluate emergency finger silicone implants for complex and comminuted fractures of the PIP joint as well as clinical and radiological complications. In this single-center, retrospective study, 13 patients operated between January 2007 and January 2019 on an emergency basis with a Neuflex® PIP arthroplasty were reviewed. This PIP joint reconstruction was associated with the soft tissue repair at the same time (skin cover, tendons, nerves) in all patients. The average age was 57.7 years with a male predominance (92%). The injuries were caused by a domestic accident in 61% of cases. The average follow-up was 4.7 years. The average total active motion arc was 183.8°. The average QuickDASH score was 24. There was one case of broken implant with no functional consequence. No infection or instability was reported. Silicone implant arthroplasty is a simple, reliable, fast, and durable solution for complex PIP fractures when conservative treatment is impossible. This solution is an alternative to arthrodesis or even finger amputation.
近节指间关节（PIP）特别容易受到创伤。在粉碎性骨折中，硅胶植入物关节成形术是一种治疗选择，但在紧急情况下可能存在争议。这种关节破坏通常伴有软组织损伤（皮肤和肌腱损伤、血运障碍），使得重建更加复杂。我们的目的是评估紧急手指硅胶植入物治疗 PIP 关节复杂和粉碎性骨折以及临床和放射学并发症。在这项单中心回顾性研究中，我们对 2007 年 1 月至 2019 年 1 月期间因紧急情况接受 Neuflex® PIP 关节成形术的 13 例患者进行了回顾。所有患者均同时进行 PIP 关节重建和软组织修复（皮肤覆盖、肌腱、神经）。平均年龄为 57.7 岁，男性居多（92%）。61%的损伤是由家庭事故引起的。平均随访时间为 4.7 年。平均总主动活动度为 183.8°。平均 QuickDASH 评分为 24。有 1 例植入物断裂，但无功能后果。无感染或不稳定的报告。当保守治疗不可能时，硅胶植入物关节成形术是治疗复杂 PIP 骨折的一种简单、可靠、快速和持久的方法。这种解决方案是融合或甚至手指截肢的替代方法。
